Paul Ryan Reverses Himself Yet Again On Medicare Cuts

When he unveils his budget plan this week, Rep. Paul Ryan (R-WI) will complete a 720-degree flip on President Obama's cuts to Medicare providers in the Affordable Care Act.

As he revealed on "Fox News Sunday," Ryan's upcoming budget will sustain the cuts.

"We end the raid and we apply those savings to Medicare to make Medicare more solvent and extend the solvency of the Medicare trust fund," he said.

Ryan ran for vice president last year against Obama's cuts to Medicare, which don't target beneficiaries but instead lower reimbursements for hospitals and private insurance companies under Medicare Advantage.

"Obamacare takes $716 billion from Medicare to spend on Obamacare," Ryan said last October. "Their own actuary from the administration came to Congress and said one out of six hospitals and nursing homes are going to go out of business as a result of this."

And yet the GOP budget chief's new position is a return to an earlier stance. His House-passed blueprints in 2011 and 2012 also assumed the same level of Medicare savings as the Affordable Care Act, while repealing the rest of the law.

But even that was a reversal after Ryan and his GOP colleagues strenuously objected to the Medicare cuts before Obamacare passed, warning as he did during the 2012 campaign that the lower provider payments would harm services for current seniors.

In other words, Ryan and Republican leaders started off opposing the ACA's Medicare cuts, then turned around and twice passed budgets that kept them, then campaigned against those cuts in the 2012 election, and are now embracing them again.

Ryan also revealed Sunday that his plan to replace Medicare with a limited subsidy for seniors to buy their own insurance won't affect people currently older than 55. His budget will include the tax hikes from the fiscal cliff, which help him balance federal spending and revenues in 10 years without targeting older Americans with his Medicare plan.

Lost in the partisan health care wars is the fact that the idea of reducing Medicare's long-term spending by cutting provider payments was embraced by Republicans long before the Affordable Care Act passed. In the 2008 election, John McCain's campaign proposed Medicare provider cuts that were similar to what Obama eventually enacted.

About The Author

Sahil Kapur is TPM's senior congressional reporter and Supreme Court correspondent. His articles have been published in the Huffington Post, The Guardian and The New Republic. Email him at sahil@talkingpointsmemo.com and follow him on Twitter at @sahilkapur.